Autoimmune Hemolytic Anemia and Neoplasia of the Reticuloendothelium

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Abstract
Two hundred and thirty-four patients with autoimmune hemolytic anemia were analyzed, and 114 examples of neoplasia of the reticuloendothelium found. The temporal sequence of this association was examined. In 31.6% of the cases both states were simultaneously discovered. The neoplastic process preceded autoimmune hemolytic anemia in 61.4% of the series. In 7 patients with 8 neoplastic growths, an incidence of 7%, autoimmune hemolytic anemia occurred prior to neopiasia. Neither autoimmune hemolytic anemia nor reticuloendothelial neoplasia are directly involved in creating the other state. The hypothesis is developed that an immunologic aberration is present in such patients which prevents the establishment of a normal immune homeostatic mechanism. The survival of immunocompetent cells which have been modified by viruses or somatic mutation, in the face of a defective immune apparatus, may result in either autoimmune hemolytic anemia, reticuloendothelial neoplasia, or both conditions. Such an abnormality may also lead to other associated neoplastic and autoimmune disease processes.